Official Recommendations Research Articles

Vaccination Coverage among Institutionalized Elderly Population: A Case Study in Cascais, Portugal

Abstract Vaccination stands as a cornerstone of public health, significantly reducing the morbidity and mortality associated with infectious diseases. However, the aging demographic, with declining homeostasis and immunosenescence, presents new challenges. Those residing in nursing homes face heightened risks of infectious diseases due to proximity and interactions with multiple staff members. In Portugal, elderly vaccination against tetanus/diphtheria (Td) is integrated into the National Vaccination Program, with additional official recommendations for pneumococcal (Pn), seasonal influenza, and COVID-19 vaccinations. Specific vaccination campaigns in nursing homes for influenza and COVID-19 are coordinated by Public Health Units. This study aimed to assess the vaccination coverage for these vaccines among the institutionalized elderly in Cascais municipality and evaluate the implementation of official recommendations. A survey of nursing homes in Cascais was conducted, and the vaccination status of residents was assessed through electronic records in February 2024. Statistical analysis was performed. Vaccination status for each vaccine was considered valid if individuals had received at least one dose of Pn13 or Pn23, a Td vaccine dose within the last 10 years, and vaccinations against influenza and COVID-19 within the last 6 months. Among 2189 institutionalized elderly in Cascais, 87% were vaccinated against both influenza and COVID-19, 39% against Td, and 17% against pneumococcal disease. While influenza and COVID-19 vaccination coverage is high, the tetanus/diphtheria vaccination rate is low, and pneumococcal vaccination is very low, despite official recommendations. This population remains at increased risk for preventable diseases. Monitoring vaccination status and implementing targeted vaccination campaigns are crucial for increasing coverage, realizing health and economic benefits and preventing severe diseases. Key messages • Vaccination is essential for safeguarding the health of institutionalized elderly populations. There is a need for targeted interventions to address preventable diseases and protect these individuals. • Monitoring vaccination status and implementing targeted campaigns are critical for increasing coverage and realizing health and economic benefits among elderly populations in nursing homes.

Handling of porous road surfaces in traffic noise calculations with Nord2000

Using porous road surfaces can be an alternative to more traditional noise reduction measures. Two factors contribute to the fact that road noise can get lower than with a conventional dense road surface: the rolling noise emission decreases, and the sound-absorbing road surface can further reduce the level. In a traffic noise calculation with Nord2000, the influence of the road surface on the sound emission is specified using road surface corrections while the acoustic surface impedance of the road surface determines the ground attenuation. However, due to measurement technical reasons, porous road surface corrections will include some (undesirable) ground attenuation, leading to that the rolling noise emission might be underestimated. Another problem is that the impedance model in Nord2000 (Delany & Bazley) does not give correct results for porous road surfaces. These complications have been investigated with Nord2000 calculations using a program code extended to also include an impedance model capable of handling porous road surfaces (Hamet et al). The results have been used to formulate official Swedish recommendations on how porous road surfaces can be handled in traffic noise investigations with Nord2000.

Using weight loss to predict outcome and define a humane endpoint in preclinical sepsis studies

Preclinical mouse models are critical for understanding the pathophysiological response to infections and developing treatment strategies for sepsis. In keeping with ethical values, researchers follow guidelines to minimize the suffering of the mice. Weight loss is a criteria used as a humane end point, but there is no official recommendation for a maximum weight loss leading to euthanasia. To evaluate whether the thresholds used in daily practice are optimal, we performed a comprehensive retrospective analysis of data generated over 10 years with > 2300 mice used in models of infection with Listeria monocytogenes, Streptococcus pneumoniae, Candida albicans and H1N1 influenza virus. Weight loss segregated mice that survived from those that did not. Statistical analyses revealed that lowering the weight loss thresholds used (none, 30% or 20%) would have increased mortality rates due to the sacrifice of mice that survived infections (p < 0.01–0.001). Power calculations showed high variability and reduction of power as weight loss thresholds approached 20% for S. pneumoniae and L. monocytogenes models. Hence, weight loss thresholds need to be adapted to each model of infection used in a laboratory. Overall, weight loss is a valuable predictor of mortality that contributes to the robustness of composite scores. To our knowledge, this is the most extensive study exploring the relationship between weight loss threshold and sepsis outcome. It underscores the importance of the infection-model-specific evaluation of weight loss for use in clinical scores defining humane endpoints to minimize mouse suffering without compromising statistical power and scientific objectives.

Complementary feeding challenges: Insights from Swiss parents’ perspectives

Parents play a crucial role in deciding what foods to introduce to their infants during the transition from milk to solids. This study examined the challenges they face, including adherence to official complementary feeding recommendations and the struggles and concerns across different stages of feeding. Specifically, this study focused on the initial stage (transition from breastmilk/formula to mashed foods), middle stage (consumption of mashed foods and some fingerfoods, transitioning towards family foods) and late stage (complete transition to family diet). Findings from 22 semi-structured interviews with Swiss parents reveal that, despite being well-informed, practical obstacles such as returning to work, limited time for preparing homemade foods, managing multiple children, and food preferences often hinder adherence. Safety concerns like allergies and choking were prominent early on but decreased as infants grew older and parents gained confidence. In the middle phase, concerns shifted towards pesticides, indicating a growing awareness of food quality. Maintaining a healthy diet was a constant concern, with early reassurance from breastfeeding or formula feeding giving way to worries about balanced nutrition as solids became more prominent. Time constraints were particularly significant in the first two stages, due to the effort of preparing small amounts of mash and later cooking separate meals. Tailored support and clear communication can help parents navigate these challenges and promote healthier feeding practices.

Treatment outcomes of standardized injectable shorter regimen for multi-drugs resistant tuberculosis in Ethiopia: a retrospective cohort study

BackgroundThe injectable shorter multi-drug resistant tuberculosis (MDR-TB) regimen, has been reported to be less costly and more effective in the treatment of MDR-TB compared to the longer regimen. Ethiopia introduced the injectable shorter regimen (SR) in April 2018 following official recommendation by the World Health Organization (WHO) in 2016. While the WHO recommendation was based on evidence coming from extensive programmatic studies in some Asian and African countries, there is paucity of information on patient outcomes in the Ethiopian context. Thus, we aimed to assess the treatment outcomes and identify factors associated with the outcomes of MDR-TB patients on injectable SR.MethodsA multi-center facility-based retrospective cohort study was conducted in Ethiopia on 245 MDR-TB patients who were treated between April 2018 and March 2020. Data were collected from patients’ medical records and analyzed using SPSS version 25. Descriptive statistics was used to summarize the results while inferential analysis was employed to investigate predictors of treatment outcomes and survival status.ResultsA total of 245 patients were included in the study, with 129 (52.7%) of them being female. Median age of the patients was 27 (IQR: 21–33). The overall treatment success rate was 87.8%, with 156 (63.7%) cured and 59 (24.1%) patients who completed treatment. The unfavorable outcomes accounted for 12.2%, with 16 (6.5%) treatment failure, 8 (3.3%) death and 6 (2.4%) lost to follow up. Majority of the unfavorable outcomes occurred during the early phase of therapy, with median time to event of 1.8 months (95% CI: 0.99—2.69). The use of khat (a green leafy shrub abused for its stimulant like effect) and being diagnosed with MDR-TB than rifampicin resistant only, were identified as independent factors associated with unfavorable outcomes.ConclusionThe injectable SR for MDR-TB was found to have positive treatment outcomes in the context of programmatic management in Ethiopia.

Cannabis use in endometriosis: the patients have their say—an online survey for German-speaking countries

PurposeEndometriosis is a chronic inflammatory disease that can cause various pain symptoms. Current therapy options do not always provide sufficient pain relief and often cause unpleasant side effects. Recent studies have shown that the endocannabinoid system is involved in the endometriosis pathophysiology, and using Cannabinoids may be a potential therapeutic option. We aimed to determine for the first time, the Cannabis use prevalence, self-rated effectiveness, and the possible reduction in medication in German-speaking countries.MethodsA cross-sectional online survey was distributed through endometriosis support and advocacy groups on social media. German-speaking endometriosis patients aged ≤ 18, residing in Germany, Austria, and Switzerland were eligible to participate.ResultsOut of 912 participants who provided valid answers, 114 reported using cannabis for self-management. Cannabis was rated as the most effective self-management strategy to reduce symptom intensity (self-rated efficacy 7.6 out of 10). Additionally, ~ 90% of the participants were able to decrease their pain medication intake. The greatest improvement was observed in sleep (91%), menstrual pain (90%), and non-cyclic pain (80%). Apart from increased fatigue (17%), side effects were infrequent (≤ 5%).ConclusionAt the time of the study, Cannabis consumption was still illegal in Germany, Austria, and Switzerland, with medical cannabis being rarely prescribed due to complex requirements. Results suggest that Cannabis has become a popular self-management method for treating endometriosis-related symptoms, leading to substantial symptom improvement. Further studies are needed to investigate the best administration methods, dosage, THC/CBD ratio, potential side effects, and long-term effects to provide official recommendations to patients and healthcare providers.

Evolving Legal Issues and Title IX

Background: Each year, several lawsuits are filed that involve peer-to-peer harassment in K–12 schools. It is important for school personnel to understand their legal obligations surrounding this issue. We highlight some recent developments in both case law and federal guidance related to peer harassment. Purpose: Students have alleged that school officials violate Title IX when they fail to appropriately respond to known acts of peer-to-peer sexual harassment at school. After providing some context, we briefly examine a case involving a victim of alleged sexual assault in a K–12 school who was disciplined by school officials for reporting sexual misconduct. We conclude with a discussion on the recent amendments to the Title IX regulations and how these new amendments could impact similar cases in the future. Research Design: Using legal research techniques, we explore illustrative case law in this area and also highlight some considerations from the recently amended Title IX regulations. Recommendations: Under Title IX and its amended regulations, school districts are tasked with creating educational environments that are free from discrimination based on sex. We offer five recommendations for school officials as they relate to this issue. These recommendations highlight recent amendments to the Title IX regulations.

The impact of sensory experiences on place attachment, place loyalty and civic participation: Evidence from Rasht, Iran

This study examines the perceptions of public spaces through the five senses on place attachment, place loyalty and civic participation. The study proposes an innovative analytical model (based on the stimulus-organism-response model) that maps the complex relationships between the five senses (sight, sound, scent, touch and taste) and desired community outcomes. An online survey was conducted with 396 residents of Rasht and the data were analyzed using structural equation modelling (SmartPLS 3). The results show that sensory experiences have a modest effect in strengthening people's attachment to the city, which in turn induces loyalty to the city and generates higher levels of civic participation. The study provides recommendations for urban planners and government officials on how best to encourage place attachment, place loyalty, and civic participation by adopting policies for promoting sensory experiences.

Tryptase in drug-induced anaphylaxis: the need for acute and baseline values.

The purpose of this narrative review was to summarize data and official recommendations purporting to paired tryptase determination in patients experiencing drug-induced anaphylaxis, published between January 1, 2023 and June 1, 2024. Three main lines of evidence obtained through paired acute and baseline tryptase determination were identified: diagnostic criterion for hypersensitivity reactions involving systemic mast cell activation; differential diagnostic criterion for hypersensitivity reactions involving other mechanisms of immediate reactions; and added value of acute and baseline tryptase levels for personalized management following drug-induced anaphylaxis: cause, risk of recurrence, underlying mast cell conditions including hereditary α-tryptasemia, familial clusters. The implementation of existing guidelines which consensually recommend paired tryptase measurement is a persistent unmet need hampering optimal diagnosis of drug-induced anaphylaxis and patient management. Another major unmet need is the lack of standardized recommendations for hereditary α-tryptasemia testing and counselling. Progress in this field is seen at a rapid pace, requiring significant efforts of continued medical education for practicing clinicians and laboratory specialists worldwide.

Immunogenicity, Safety and Efficacy of the Dengue Vaccine TAK-003: A Meta-Analysis.

The TAK-003 dengue vaccine was licensed in Europe in December 2022, and the official recommendations from most EU countries are still under formulation. To support policymakers, we performed a meta-analysis to quantify TAK-003's immunogenicity, efficacy and safety among seronegative and seropositive populations after the administration of one or two vaccine doses. We included trials retrieved from MEDLINE, Scopus and ClinicalTrials.gov. The outcomes were the rates of seroconversion, virologically confirmed dengue fever and serious adverse events after each vaccine dose. Data were combined using random-effect proportion or head-to-head meta-analyses. We retrieved a total of 19 datasets, including >20,000 participants. TAK-003 showed an excellent safety profile, and the immunogenicity after two doses against the four DENV serotypes was ≥90% among both adults and children/adolescents who were either seronegative or seropositive at baseline. A single dose was able to elicit a high immunogenic response among adults (≥70%) and children/adolescents (≥90%). The primary two-dose immunization course halved the risk of all types of virologically confirmed dengue fever among seropositive children/adolescents, but seronegative minors were only protected against the diseases caused by DENV-1 and DENV-2. Overall, the results support the use of TAK-003 for the prevention of dengue fever in the pediatric population of endemic countries. Uncertainties remain on the use of a single vaccine dose in non-endemic countries.

PROTEIN RECOMMENDATIONS FOR VEGETARIANS AND VEGANS

Objective: Analyze official protein recommendations for vegan and vegetarian individuals in all life stages. Methods: Integrative review carried out with official recommendations from six different countries and one continent, found in the PubMed database e Google Scholar. This study included articles with official recommendations from different countries, published in the last ten years in English, Spanish or Portuguese. Results: In the search, after analyzing the titles and abstracts, seven articles were considered for the study. Conclusions: Considering only proteins, it is possible to have a healthy vegetarian diet, provided that individuals are careful with protein consumption so that the daily recommendations are met and there is not any deficiency related to this macronutrient. However, in vegan diets, individuals should have greater caution since these only include plant protein sources which have lower bioavailability and, therefore, need to be consumed in a bigger quantity and from various different sources throughout the day. Nutritional assistance is essential in this dietary choice.

Study on Factors of Urban Transportation Service Quality Based on Analytic Hierarchy Process: A Case Study of Gangtok City

Promoting the use of public transportation requires an in - depth knowledge of the variables that affect the choice of public transportation mode, including the process of implementing policy, as it has become a crucial component of government strategies to reduce carbon emissions from the transportation sector globally. A variety of factors impacting the usage of public transportation have been identified in previous studies, but few have been included in a single study. In order to boost the use of public transportation, it is essential to make it more attractive to travellers by conducting frequent Service Quality (SQ) assessments and adjustments. Understanding the passengers’ expectations towards public transportation are important, and assessing the SQ is an important tool for evaluating the total performance of the Gangtok’s public transportation system. The purpose of the existing study was to study the expectations and perceptions of city’s passengers regarding SQ in public transportation. In order to comprehend how the present commuters’ prefer a particular service quality attribute a series of interviews with passengers were undertaken. MCDM technique was adopted for this. The paper focuses on service quality factors for urban transportation system by adopting AHP technique. In this study perception of passengers using public transport in Gangtok is taken from the field. The case study is taken for Gangtok city in the state of Sikkim. The study involves study of passengers from various bus stop locations of the city. The results of the research showed substantial discrepancies among expectations and perceptions of city’s commuters, along with widespread dissatisfaction with the delivery of public transit services in hilly areas as a whole. The reliability and adaptiveness of these service have been critical in describing the overall quality of transportation services in hilly areas, and best practices were used to develop a set of recommendations for transportation operators and local officials.

SOCIAL AND PSYCHOLOGICAL RESOURCES OF CHILDREN WITH SPECIAL EDUCATIONAL NEEDS (DIAGNOSTIC CONTEXT IN BULGARIA AND RUSSIA)

Background. The paper describes ways of diagnosing social and psychological resources of children with special needs. The authors propose to study the diagnostic capabilities of socialization of children with special needs as a unique integrative tool in the work of specialists getting in touch with children with special needs (inclusive education, special education). Two aspects of diagnostics of socialization of preschool children with special needs in Bulgaria and Russia who are provided with inclusive education according to official procedures are considered. The research hypothesis is the assumption of inclusion of multiple characteristics of socialization of preschool children, which can serve as resources for successful social adaptation of children with special needs. The purpose of the study is to structure the review based on the grouping of parameters related to the characteristics of adaptive socialization resources in the context of meeting special needs. Methodology. The study was carried out in accordance with the theoretical and methodological principles of psychology and pedagogy and the special methodology of psychological science (the principle of personal approach), the following methods were used (analysis; synthesis; abstraction and specification; comparison and generalization; method of induction and deduction, method of analogies; modeling). The results are based on introductory studies of official recommendations for research on socialization of children with special needs in earlier studies conducted in both countries. It is shown that most of the target socialization scales are the same and are reflected in the predictive research procedure. In addition, it has been proven that in Bulgaria the scales are more substantive about the child's conditions and developmental situation, while in Russia they refer to the child's personal and socio-psychological indicators. In Bulgaria, there is no tendency to emphasize the functions of socialization areas, while in Russia, a number of diagnostic tests emphasize the socialization areas of the preschool child with special needs. Practical implications. This Russian peculiarity allows us to refer to the method of prediction level measurement as an integral and unique tool which includes socialization parameters through refraction of personal characteristics of a child with special needs in various spheres of his/her relations (parents, adults, peers) and ways of organization of activity (organized and free), i.e. conditions of social development. In conclusion, in both countries it is necessary to redirect diagnostic methods to more integrative methods of work. In Bulgaria, more attention needs to be paid to comprehensiveness, and in Russia, the specificity of developmental disorders must be monitored.

Mental health and the overall tendency to follow official recommendations against COVID-19: A U-shaped relationship?

This paper investigates the association between several mental health indicators (depression, anxiety, stress, and loneliness) and the overall tendency to follow official recommendations regarding self-protection against COVID-19 (i.e., overall compliance). We employ panel data from the COME-HERE survey, collected over four waves, on 7,766 individuals (22,878 observations) from France, Germany, Italy, Spain, and Sweden. Employing a flexible specification that allows the association to be non-monotonic, we find a U-shaped relationship, in which transitions to low and high levels of mental health are associated with higher overall compliance, while transitions to medium levels of mental health are associated with less overall compliance. Moreover, anxiety, stress, and loneliness levels at baseline (i.e., at wave 1) also have a U-shaped effect on overall compliance later (i.e., recommendations are followed best by those with lowest and highest levels of anxiety, stress, and loneliness at baseline, while following the recommendations is lowest for those with moderate levels of these variables). These U shapes, which are robust to several specifications, may explain some of the ambiguous results reported in the previous literature. Additionally, we observe a U-shaped association between the mental health indicators and a number of specific health behaviours (including washing hands and mask wearing). Importantly, most of these specific behaviours play a role in overall compliance. Finally, we uncover the role of gender composition effects in some of the results. While variations in depression and stress are negatively associated with variations in overall compliance for men, the association is positive for women. The U-shaped relation in the full sample (composed of males and females) will reflect first the negative slope for males and then the positive slope for females.

Personalized Nutrition with Banked Human Milk for Early Gut Microbiota Development: In Pursuit of the Perfect Match.

The correct initial colonization and establishment of the gut microbiota during the early stages of life is a key step, with long-lasting consequences throughout the entire lifespan of the individual. This process is affected by several perinatal factors; among them, feeding mode is known to have a critical role. Breastfeeding is the optimal nutrition for neonates; however, it is not always possible, especially in cases of prematurity or early pathology. In such cases, most commonly babies are fed with infant formulas in spite of the official nutritional and health international organizations' recommendation on the use of donated human milk through milk banks for these cases. However, donated human milk still does not totally match maternal milk in terms of infant growth and gut microbiota development. The present review summarizes the practices of milk banks and hospitals regarding donated human milk, its safety and quality, and the health outcomes in infants fed with donated human milk. Additionally, we explore different alternatives to customize pasteurized donated human milk with the aim of finding the perfect match between each baby and banked milk for promoting the establishment of a beneficial gut microbiota from the early stages of life.

(138) ARE WE THERE YET? ASSESSING OUR CURRENT STATE OF SEX MED EDUCATION

Abstract Introduction Sexual concerns are prevalent, but studies have demonstrated that patients often feel most comfortable if the clinician initiates the conversation. Many patients are hesitant to discuss sexual concerns with their providers for a variety of reasons including fear of judgment, lack of clinician knowledge, and concerns that these issues are abnormal or unusual. Clinician education plays an important role in helping to facilitate these difficult conversations. However, there has never been a broad assessment of education across medical training programs, while the most recent assessment of MD training programs occurred approximately a decade ago. Objective We set out to create and administer a survey to assess sexual medicine training across most major medical disciplines where sexual health matters may be discussed, including nurse practitioner, midwifery, physician, and physician assistant training. Methods A subcommittee of the ISSWSH Advocacy Committee was formed with members representing the medical disciplines to be surveyed. A survey was developed to gather data on sexual medicine education offered at nursing, midwifery, physician, and physician assistant training programs. The survey included a series of questions regarding content taught during these programs (checklists, open ended responses). The survey was approved by the Wake Forest IRB and distributed using RedCap to various institutions from the above disciplines throughout the United States. Results We received a total of 33 complete responses. 88.5% of respondents stated they used traditional lecture as their teaching method, whilst only 11.5% used simulation, and 7.7% used actual mechanical models. The majority of programs that responded spent 3-5 hours total dedicated to human sexuality and sexual function education. Interestingly, respondents noted that faculty involved in sexual medicine education were mostly OB/GYN in background (63%), followed by family medicine (18.5%) and urology (18.5%). While not all respondents indicated that their students were assessed on their knowledge after teaching, it was noted that the majority of programs that did respond indicated that examination was the most common mode of assessment. Only 33% of institutions noted having a regional or nationally recognized expert in the field. Conclusion It is essential that the accrediting bodies for medical programs incorporate the input of international societies such as ISSWSH (in collaboration with other sexual medicine organizations) to formulate an official statement and recommendations for a standardized curriculum for sexual medicine.

Opportunities and challenges to the development and deployment of vaccines for pregnant women in Germany

Maternal immunisation is a powerful tool to protect both pregnant women and their children. A new maternal RSV vaccine holds promise to protect newborns from RSV-associated illness in the first few months of life, but no official recommendation has been made in Germany. Since RSV causes a significant burden of paediatric hospital admissions, we consider it a pertinent opportunity to review barriers to maternal vaccination in Germany, which might also apply to other settings. Access to vaccination for pregnant women in Germany is shaped by an interplay of legal, regulatory, institutional, and sociocultural factors, with a less permissive clinical research environment, delays in recommendation and roll-out, and lower acceptance by healthcare professionals and the population. Actionable recommendations to improve availability and uptake include coordination with other national regulatory bodies to reduce delays, awareness and literacy campaigns for health professionals and the general public, and capacity building for vaccine clinical research.

Evaluating the Reliability of Health Portals' Nutrition and Supplementation Advice for Pregnant Women: A Comprehensive Review.

This article evaluates the reliability and consistency of nutrition- and supplementation-related advice for pregnant women provided by ten selected health-related Internet portals. The portals were chosen based on their perceived reliability and prominence in Google searches, with representation from both English and Polish language sources. The evaluation criteria included the adherence of the presented information to official recommendations and its evidence-based character based on specific items representing dietary aspects important in pregnancy. While the overall reliability was deemed acceptable, significant variations existed both among the portals and specific evaluated items. Notably, HealthLine, Medline Plus, and NCEZ emerged as the most evidence-based, while WebMD and Medycyna Praktyczna were identified as less reliable. Despite a number of issues, the analysed portals remain valuable sources of nutritional information for pregnant women, offering user-friendly accessibility superior to alternatives such as social media on the one hand and scientific articles on the other. Improved consistency and attention to detail, especially in relation to vitamin intake and supplementation, would improve the overall quality of health portals.

Thromboembolic prevention in athletes: management of anticoagulation in sports players affected by atrial fibrillation.

Atrial fibrillation (AF) is a common cardiac arrhythmia that poses a significant risk of stroke and thromboembolic events. Anticoagulation therapy is essential for preventing stroke in patients with AF. An increasing number of people of all ages, including cardiac patients, approach physical activity as both a leisure-time exercise and a competitive sport. Therefore, patients at risk of AF are increasingly allowed to practice sports activities. Management of oral anticoagulant therapy (OAT) in these patients is extremely challenging because of the need to balance the risks and benefits of medications, considering both hemorrhagic (in case of trauma) and ischemic complications when the drugs are avoided. Official recommendations are limited for these patients and forbid sports that increase the risk of trauma and consequent bleeding in most cases. These recommendations are strongly influenced by the "traditional" management of OAT, which mainly involves coumarin derivatives. Non-vitamin K antagonist direct oral anticoagulants (DOACs), with their more favorable pharmacokinetic-pharmacodynamic profile than that of coumarin derivatives, may represent an opportunity to modify the approach to sports activity in patients with AF and indications for OAT. This study aimed to review the use of anticoagulants in athletes with AF, highlight their efficacy and safety, and provide practical considerations regarding their management.

Roadmap to Smart Cities in Saudi Arabia: Key Challenges and Opportunities

Technologies are constantly evolving and finding applications in both business and government organizations for various purposes such as improving operational efficiency, increasing customer satisfaction, and reducing the cost of transactions. Technology adoption is a well-researched phenomenon in the academic world. Based on the current state of e-governance in Saudi cities and the potential of Artificial Intelligence (AI), Internet of Things and Blockchain in e-governance, this research study aims to study factors influencing the adoption intention of AI and Blockchain technologies in citizen services delivery within a smart city in Saudi. This article explores AI, IoT and Blockchain technologies adoption intention in the context of smart cities within a developing country like Saudi. Finally, the study provides a set of practical recommendations for smart city officials while planning to launch service applications using AI and Blockchain technologies. More specifically, the study emphasizes the importance of ethics, data privacy and security, and transparency in building trust between smart city systems.